Suprachoroidal drainage of aqueous humour with a novel implant: Suprajet

AIM: To evaluate the efficacy and safety of a new implant, Suprajet(VSY Biotechnology, Istanbul, Turkey), which is developed for supraciliary and suprachoroidal drainage of aqueous humour.METHODS: Five rabbits were included in the study. One Suprajet shunt was implanted in one eye of each rabbit. Implantation was performed by a superior clear corneal incision through the anterior chamber into the suprachoroidal space. Proximal end of the implant was placed in the iris root resting against the scleral spur, distal end was placed in the suprachoroidal space. Rabbits were followed for 4wk. Preoperative and postoperative intraocular pressure(IOP)levels were measured with Tonopen AVIA. At last follow-up visit animals were sacrificed and eyes were enucleated. Macroscopic and histopathologic evaluation of the eyes were made. RESULTS: Mean preoperative IOP was 18.6±6.1 mmHg. Mean postoperative IOP was 8.4±1.1 mmHg, at one week. At the 2nd week of the follow-up period one rabbit died. Thereafter, only 4 rabbits were followed. Mean postoperative IOP was 11.0±2.8 mmHg at the 2nd week, 9.50±3.1 mmHg at the 3rd week and 11.3 ±3.3 mmHg at 4th week after the operation. When mean preoperative IOP was compared with the postoperative IOP values, only the IOP at the first week was found as significantly lower(P=0.042). There was no statistically significant difference between mean preoperative IOP level and mean IOP level at 2, 3 and 4wk postoperatively(P=0.66, P=0.66 and P=0.102, respectively). As an intraoperative complication, minimal hyphema was noted in three eyes during the surgery. However, the next day hyphema cleared completely. Macroscopic evaluation of the enucleated material showed that in one eye the distal end of the implant was in the vitreous instead of suprachoroidal space, in the other 3 eyes the distal end of the implant was noted in the suprachoroidal space. In all eyes, proximal end of the implant was localized in the anterior chamber angle. Histopathologic evaluation of the enucleated eyes showed deposition of irregular collagen bundles and fibroplasia including numerous fibroblastic and histiocytic cells around the implant.CONCLUSION: This preliminary animal study showed that implantation of Suprajet in glaucoma is a promising procedure. Further studies are needed to evaluate its efficacy and safety profile

Ahmed Glaucoma Valve Implantation to Reduce Intraocular Pressure: Updated Perspectives

Trabeculectomy and glaucoma drainage device implantation are the most commonly performed glaucoma surgeries worldwide. Although trabeculectomy is the gold standard, at the present time there is an increase in the use of glaucoma drainage devices. The Ahmed glaucoma valve is one of the most widely used glaucoma drainage devices worldwide. Corneal endothelial cell loss and eventually corneal decompensation is one of the serious complication of glaucoma drainage device implantation. To avoid this, drainage tube can be inserted into the ciliary sulcus instead of the anterior chamber, especially in eyes with high risk for corneal decompensation. Tube/plate exposure, hypertensive phase, endophthalmitis, cataract formation, diplopia and ocular hypotony are the other potential complications that can develop after Ahmed glaucoma valve implantation

AOP*** Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation Ophthalmology Practice

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o'clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases. In-the-bag intraocular lens (IOL) subluxation is a rare but serious complication even after an uneventful cataract surgery. Bag dislocation may occur as a result of progressive zonular dehiscence many years after the surgery. [1-3] Capsular tension ring (CTR) implantation provides a reasonable preventive measure from the complication of in-the-bag IOL dislocation by supporting the zonules after cataract surgery, however, late spontaneous IOL and CTR dislocation within the intact capsular bag in patients with pseudoexfoliation is reported in the literature. Surgical Technique We had two patients whose subluxated IOLs and were managed with trans-scleral fixation. Six years after an uneventful phacoemulsification combined with viscocanalostomy surgery, first patient presented to us because of the blurred vision of her left eye. Inferiorly subluxation of the IOL along with its capsule like a setting sun was detected on slit-lamp biomicroscopic examination. Under topical anesthesia, two conjonctival peritomies were created from 2-4 o'clock and 8-10 o'clock at both temporal and nasal limbus. A clear corneal incision was performed at 12 o'clock. In order to protect the corneal endothelium as well as expand the posterior chamber, the anterior chamber and the retropupillary space were filled with an ophthalmic viscosurgical device (OVD). Four additional clear corneal side port incisions were performed for the placement of iris hooks to dilate the pupil. A double-armed 10-0 polypropylene suture on straight needles (Prolene ® , Ethicon Inc) was cut in half. One straight needle was inserted into the globe from pars plana at 9 o'clock quadrant and passed through the ciliary sulcus and the intact capsular bag around the edge of CTR posterior-anteriorly

Long-term results of viscocanalostomy and phacoviscocanalostomy: a twelve-year follow-up study

AIM: To evaluate the long-term efficacy and safety results of viscocanalostomy and phacoviscocanalostomy. METHODS: The charts of 49 glaucoma patients who underwent viscocanalostomy or phacoviscocanalostomy surgery between February 1999 and August 2004 were reviewed retrospectively. Thirty-one eyes of 21 glaucoma patients who underwent filtering procedure with a postoperative follow-up of at least 5y were included in the study. Results of complete ophthalmologic examinations were recorded and statistically analyzed. Long-term surgical outcome was defined as an overall success when intraocular pressure (IOP) was found as ≤20 mm Hg with or without antiglaucomatous medication at the last follow-up visit, while it was defined as a complete success when IOP was measured ≤20 mm Hg without antiglaucomatous medication. RESULTS: Mean age was 68.1±9.6y (range: 32-81y). Mean follow-up time was 101.5±27.3mo (range: 60-144mo). Viscocanalostomy was performed in 8 eyes (25.8%) and phacoviscocanalostomy was performed in 23 eyes (74.2%). The mean preoperative IOP was 23.1±7.6 mm Hg with 2.1±1.0 medications, while mean IOP was 16.8±3.8 mm Hg with 0.9±1.1 medication at the last follow-up visit. Both the IOP decrease and the reduction in the antiglaucomatous medication were statistically significant (P<0.001 and P<0.001). No case required further glaucoma surgery. Overall success and complete success were found as 87.1% and 51.6%, respectively. Complete success rate was statistically higher in phacoviscocanalostomy group compared with the viscocanalostomy group (P=0.031), however there was no significant difference in overall success rate between two groups (P=0.072). CONCLUSION: Both viscocanalostomy and phacoviscocanalostomy provide good IOP reduction in the long-term period

Surgical management of spontaneous in-the-bag intraocular lens and capsular tension ring complex dislocation

We describe a technique to manage late spontaneous intraocular lens (IOL) and capsular tension ring (CTR) dislocation within the intact capsular bag. The subluxated IOL and CTR complex can be positioned in a closed chamber and fixed to the pars plana at both 3 and 9 o′clock quadrants with the presented ab externo direct scleral suturation technique which provides an easy, safe and effective surgical option for such cases

Topically applied 1% voriconazole induces dysplastic changes on the ocular surface: animal study

Purpose: To identify the risk of inducing ocular surface dysplasia following topical administration of 1% voriconazole eye drop

Evaluation of the Cataract Surgery 2018 Survey in Terms of Achieving Refractive Cataract Surgery Targets

Objectives: The aim of this study was to show at what rate the technological equipment used in cataract surgery by Turkish ophthalmologists and their knowledge are reflected in practice and how up to date they are